Comparison of refractive outcomes in patients following scleral fixated intraocular lens implantation with Yamane and Z-suture techniques.

Purpose: To compare visual and refractive outcomes in aphakic patients who underwent scleral fixated intraocular lens (SF-IOL) implantation with Yamane and Z-suture techniques.

Design: Retrospective study.

Methods: Patients who underwent SF-IOL implantation with Yamane and Z-suture techniques due to aphakia between 2021 and 2023 were analyzed. Preoperative and postoperative 6. month best corrected visual acuity (BCVA-LogMAR), preoperative and postoperative spherical error, cylindrical error and postoperative mean absolute error (MAE), corneal endothelial and topographic parameters, 3 mm-6 mm pupil diameter corneal higher-order aberrations (HOAs) were evaluated.

Results: Seventy-seven eyes of 77 patients who underwent SF-IOL implantation with Yamane and Z-suture techniques were included in the study. Yamane technique was performed in 38 (49.4%) and Z-suture technique in 39 (50.6%) patients. Postoperative BCVA was 0.44 ± 0.40 in Yamane technique and 0.47 ± 0.44 in Z-suture technique (p = 0.73). Postoperative MAE was 0.84 ± 0.70 D in Yamane technique, 1.02 ± 0.88D in Z-suture technique (p = 0.33). Postoperative CCT-preoperative CCT (ΔCCT) was 3.76 ± 27.62 µm in Yamane technique and 3.02 ± 15.58 µm in Z-suture technique (p = 0.88). A significant difference was found between Yamane and Z-suture techniques only in the ΔTrefoil value at 6-mm pupil diameter in corneal HOAs. ΔTrefoil was significantly lower in Yamane technique (p = 0.04).

Conclusion: Except ΔTrefoil value at 6-mm pupil diameter, although no significant difference was found, corneal endothelial and topographic parameters were less affected in Yamane technique compared to Z-suture technique.